1.1. Objectives
Bicuspid aortic valve (BAV) patients can develop thoracic aortic aneurysms (TAA) and therefore require serial imaging to monitor aortic growth. This study investigates the reliability of contrast-enhanced MR angiography (CEMRA) volumetry compared to two-dimensional diameter measurements to identify TAA growth.
1.2. Materials and Methods
A retrospective, IRB approved and HIPAA compliant study was conducted on 20 BAV patients (45±8.9 years old, 20% women) who underwent serial CEMRA with a minimum imaging follow-up of 11 months. MRI was performed at 1.5 T with ECG-gated time-resolved CEMRA. Independent observers measured the diameter at the sinuses of Valsalva (SOV) and mid-ascending aorta (MAA) as well as ascending aorta volume between the aortic valve annulus and innominate branch. Intra/inter-observer coefficient of variation (COV) and intraclass correlation coefficient (ICC) were computed to assess reliability. Growth rates were calculated and assessed by Student’s t-test (p<0.05 significant). The diameter of maximal growth (DMG), defined as the diameter at SOV or MAA with the faster growth rate, was recorded.
1.3. Results
The mean time of follow-up was 2.6±0.82 years (y). The intraobserver COV was 0.01 for SOV, 0.02 for MAA, and 0.02 for volume (interoberserver COV: 0.02, 0.03, 0.04, respectively). The ICC was 0.83 for SOV, 0.86 for MAA, 0.90 for DMG, and 0.95 for volume. Average aortic measurements at baseline and (follow-up) were 42±3 mm (42±3 mm, p=0.11) at SOV, 46±4 mm (47±4 mm, p<0.05) at MAA, and 130±23 mL (144±24 mL, p<0.05). Average size changes were 0.2±0.6 mm/y (1%±2%) at SOV, 0.5±0.8 mm/y (1%±2%) at MAA, 0.7±0.7 mm/y (2%±2%) at DMG, and 6±3 mL/y (4%±3%) with volumetry.
1.4. Conclusions
3D CEMRA volumetry exhibited a larger effect when examining percentage growth, a better ICC, and a marginally lower COV. Volumetry may be more sensitive to growth and possibly less affected by error than diameter measurements.
Superficial angiomyxoma (SA) is a rare benign soft‐tissue tumor, arising sporadically or as the earliest manifestation of Carney's complex. When it arises sporadically, the breast is infrequently involved with only few cases reported in the literature. Key imaging findings include T2 signal hyperintensity on MRI and hypervascularity. In this study, we report the clinical, radiological, surgical, and histopathologic findings of a case of sporadic SA of the breast in a 16‐year‐old girl.
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